New York Nurses Strike Ends in Major Victory: What the Tentative Agreements Mean for Healthcare Labor

By Nana Kazhiloti, Credentialing Department, WCH

Historic Strike Concludes with Landmark Protections

After four weeks on picket lines in freezing temperatures, approximately 10,500 nurses at Montefiore Medical Center and the Mount Sinai hospital system have reached tentative agreements that represent a significant victory for healthcare labor organizing. The contracts, announced in early February, address critical issues ranging from staffing ratios to workplace violence protections—and break new ground by including safeguards against artificial intelligence deployment in patient care. The strike, which began on January 12 and became one of the largest and longest nurse strikes in New York City history, demonstrates the growing power of healthcare workers to reshape working conditions in an industry facing unprecedented staffing challenges and technological disruption.

What Nurses Won

The tentative agreements contain several provisions that extend beyond traditional wage and benefit negotiations:

Enforceable Safe Staffing Standards: The contracts establish and maintain specific nurse-to-patient ratios with enforcement mechanisms. This addresses what nurses identified as their primary concern—the ability to provide safe patient care. Unlike advisory staffing guidelines, these ratios carry contractual weight, giving nurses legal recourse if violated.

AI Safeguards: The agreements include forward-looking protections addressing the use of artificial intelligence in healthcare settings. As AI tools increasingly enter hospital workflows—from predictive algorithms to automated documentation systems—the contractual language ensures AI cannot replace nurses or be used for discipline or staffing decisions, and that human oversight remains paramount. These provisions address emerging concerns about technology’s role in clinical care and may influence healthcare labor negotiations nationwide as the industry continues adopting AI technologies.

Workplace Violence Protections: The agreements strengthen security measures and protocols to protect nurses from physical assault, a growing problem in healthcare settings. Studies show healthcare workers face violence rates significantly higher than other sectors, with emergency department and psychiatric nurses particularly vulnerable.

Immigration and Trans Patient Protections: The contracts reaffirm protections for immigrant and transgender patients and staff—provisions that reflect nurses’ professional ethics codes requiring equitable care regardless of patients’ backgrounds, and protecting workforce diversity.

Economic Terms: Nurses secured salary increases exceeding 12% over three years, addressing retention challenges in a competitive healthcare labor market. Critically, they also beat back hospital attempts to shift healthcare costs onto workers, maintaining health benefits with no additional out-of-pocket expenses.

The Broader Context

This victory occurs against a complex healthcare labor landscape. The American Nurses Association reports that hospitals nationwide face critical nursing shortages, with turnover rates reaching 27% in some regions. The COVID-19 pandemic accelerated burnout and departures, while simultaneously demonstrating the essential nature of adequate nurse staffing. The strike’s timing and scope reflect broader labor organizing momentum. According to Cornell University’s ILR School Labor Action Tracker, 2023 saw significant strike activity across healthcare, with workers increasingly willing to walk out over working conditions rather than solely wages. The New York nurses’ willingness to sacrifice four weeks of pay—and their own healthcare coverage during the strike — to secure patient safety provisions represents a values-driven approach to collective action.

What Remains Unresolved

At the time of the agreements, approximately 4,200 nurses at NewYork-Presbyterian Hospital continued striking, with safe staffing remaining the key sticking point. This suggested that while Montefiore and Mount Sinai recognized that prolonging the strike was untenable, not all hospital systems had reached this conclusion. The divergence also highlights different institutional approaches to nurse staffing. NewYork-Presbyterian’s continued resistance to enforceable ratios may reflect different financial constraints, patient population characteristics, or philosophical disagreements about how to balance staffing flexibility with safety guarantees.

Implications for Healthcare Delivery

The agreements’ emphasis on staffing ratios addresses well-documented connections between nurse workload and patient outcomes. Research published in medical journals consistently shows that higher nurse-to-patient ratios correlate with increased mortality rates, longer hospital stays, and higher rates of complications. California’s experience with legally mandated ratios provides evidence that such standards are implementable, though hospital administrators often cite cost concerns and operational challenges. The AI provisions are particularly significant given healthcare’s trajectory. As hospitals invest billions in clinical decision support systems, automated charting, and predictive analytics, the question of human oversight becomes critical. The contracts acknowledge that while AI may enhance clinical capabilities, nurses’ professional judgment must remain central to patient care decisions.

The Political Dimension

New York State Nurses Association President Nancy Hagans framed the victory as protecting “safe patient care for all of New York,” connecting workplace conditions to community health. This framing, presenting the strike not as narrow self-interest but as public service advocacy, helped maintain public support during the month-long action. Executive Director Pat Kane’s statement that “we helped galvanize a movement for worker and healthcare justice that reached beyond New York City” positions the strike within broader labor organizing efforts. Whether these contracts indeed catalyze similar actions elsewhere will depend on multiple factors: hospital financial positions, state labor laws, and nurses’ willingness to strike in other markets.

Ratification votes scheduled for February 9-11 will determine whether these tentative agreements become binding contracts. If ratified, nurses would return to work on February 14 with enhanced protections and the knowledge that sustained collective action achieved measurable results. The agreements may influence upcoming healthcare labor negotiations nationwide. Hospitals facing nursing shortages may find that offering enforceable staffing protections becomes necessary to recruit and retain staff. Alternatively, financially struggling hospitals may dig in against such provisions, leading to more labor conflicts. The AI provisions deserve particular attention as healthcare technology evolves. If these protections prove workable without hindering beneficial AI adoption, they could become standard language in healthcare labor contracts. If they create implementation challenges, hospitals may resist similar provisions elsewhere. The New York nurses’ strike victory demonstrates that healthcare workers can secure meaningful improvements in working conditions through sustained collective action. The agreements go beyond traditional economic terms to address fundamental questions about patient care, technological change, and workplace safety. Whether this represents a turning point for healthcare labor or an isolated success story will emerge over the coming years as other hospitals face similar organizing efforts. For now, approximately 10,500 nurses return to work having demonstrated that in healthcare labor disputes, when workers prioritize patient safety alongside their own interests, they can build the public and political support necessary to win.

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Sources

 1. New York State Nurses Association. “Victory: Nurses at Montefiore, Mount Sinai Hospital, and Mount Sinai Morningside and West Reach Tentative Agreements to End Strike. Press release, February 2025.

2. American Nurses Association. “Nursing Workforce Statistics and Trends.” Available at: https://www.nursingworld.org/practice-policy/workforce/

3. Cornell University ILR School. “Labor Action Tracker.” Available at: https://striketracker.ilr.cornell.edu/

4. Aiken, L.H., et al. “Hospital Nurse Staffing and Patient Mortality, Nurse Burnout, and Job Dissatisfaction.” JAMA, 288(16), 2002, pp. 1987-1993.

5. National Nurses United. “About NNU.” Available at: https://www.nationalnursesunited.org/  

6. U.S. Bureau of Labor Statistics. “Occupational Outlook Handbook: Registered Nurses.” Available at: https://www.bls.gov/ooh/healthcare/registered-nurses.htm  

7. The Joint Commission. “Workplace Violence Prevention Resources.” Available at: https://www.jointcommission.org/  

8. California Department of Public Health. “Hospital Nurse Staffing Ratios.” Available at: https://www.cdph.ca.gov/